立体定向手术治疗脑深部病变及运动异常(附32例报告)

目的分析立体定向手术对脑深部病变及运动异常的临床应用价值。方法采用CT或MRI定位对脑深部囊性病变进行治疗,对诊断不明确的病变进行活检,对帕金森病、痉挛性脑瘫等运动异常进行射频毁损治疗。结果2例活检的病例均明确了病变性质;随访2~20个月,3例脑深部病变者好转,10例帕金森病患者4例术后震颤、强直消失停用左旋多巴,4例左旋多巴减量至术前1/2~1/3;11例脑瘫及4例特发性震颤患者好转,1例癫痫伴精神症状者无效;无术后昏迷、偏瘫、感染、手术死亡。结论立体定向手术创伤小、安全性高,对脑深部病变的诊断和治疗以及运动异常的治疗有积极应用价值。

Deep-seating cerebral lesions and movement disorders treated by stereotactic operations (report of 32 cases)

Objective To analyze the value of stereotactic operation for the treatment of deep-seating cerebral lesions and movement disorders.Methods With the guide of CT/MRI,deep-seating cerebral lesions were treated by stereotactic asporation or cyst-ventriculo-peritoneal shunt,biopsy and movement disorders were treated by thalamotomy or/and pallidotomy.Results The biopsy cleared the diagnosis.During the 2-20 months follow-up period,L-dopa was withdrawn in 4 of the 8 Parkinson disease patients and decreased to 1/2 or 1/3 of pre-operation dosage in other 4 patients.The symptoms were improved in cerebral palsy and essential tremor patients.There was no fatal complication.Conclusion Stereotactic operation is a safe and effective measure for the treatment of deep-seating cerebral lesions and movement disorders.